Abstract
Objectives: We sought to investigate the long-term clinical outcomes of patients with coronary artery aneurysm (CAA) after drug-eluting stent (DES) implantation, compared with patients without CAA. Background: CAA developed after DES implantation is a rare but associated with poor clinical outcome. Methods: We retrospectively compared 78 patients with CAA after DES implantation with 269 patients without CAA who underwent DES implantation for complex lesions (controls). The primary endpoint was defined as major adverse cardiac events (MACE), the composite of all-cause death, nonfatal myocardial infarction (MI), and target lesion revascularization (TLR). Results: Morphologically, CAAs were saccular (32%), fusiform (13%), or microform (55%). The stent types involved were Cypher (n=56, 71.8%) and Taxus (n=22, 28.2%). During a median follow-up period of 1164 days, the incidence of MACE was significantly higher in the CAA group (26.9 vs. 2.2%, P<0.001); the difference was driven mainly by nonfatal MI (11.5 vs. 0%, P<0.001) and TLR (20.5 vs. 1.9%, P<0.001). The incidence of stent thrombosis was higher in the CAA group (12.8 vs. 0.74%, P<0.001), irrespective of the maintenance of dual antiplatelet therapy. In the CAA group, Cox regression analysis showed significantly higher hazard ratios of CAA for MACE during the follow-up period. Further analyses after propensity-score matching of 65 pairs also showed similar results. Conclusions: The incidence of MACE was higher in patients with CAA compared with patients without CAA after DES implantation. This difference was driven by TLR and nonfatal MI and widened over time.
| Original language | English |
|---|---|
| Journal | Catheterization and Cardiovascular Interventions |
| DOIs | |
| Publication status | Accepted/In press - 2017 Jan 1 |
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Keywords
- Coronary artery aneurysm
- Drug-eluting stent
- Major adverse cardiac event
- Percutaneous coronary intervention
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine
Cite this
Clinical outcomes of patients with coronary artery aneurysm after the first generation drug-eluting stent implantation. / Joo, Hyung Joon; Yu, Cheol Woong; Choi, Rakkyeong; Park, Jinsik; Lee, Hyun Jong; Kim, Je Sang; Choi, Young Jin; Park, Jae Hyoung; Hong, Soon Jun; Lim, Do-Sun.
In: Catheterization and Cardiovascular Interventions, 01.01.2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Clinical outcomes of patients with coronary artery aneurysm after the first generation drug-eluting stent implantation
AU - Joo, Hyung Joon
AU - Yu, Cheol Woong
AU - Choi, Rakkyeong
AU - Park, Jinsik
AU - Lee, Hyun Jong
AU - Kim, Je Sang
AU - Choi, Young Jin
AU - Park, Jae Hyoung
AU - Hong, Soon Jun
AU - Lim, Do-Sun
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Objectives: We sought to investigate the long-term clinical outcomes of patients with coronary artery aneurysm (CAA) after drug-eluting stent (DES) implantation, compared with patients without CAA. Background: CAA developed after DES implantation is a rare but associated with poor clinical outcome. Methods: We retrospectively compared 78 patients with CAA after DES implantation with 269 patients without CAA who underwent DES implantation for complex lesions (controls). The primary endpoint was defined as major adverse cardiac events (MACE), the composite of all-cause death, nonfatal myocardial infarction (MI), and target lesion revascularization (TLR). Results: Morphologically, CAAs were saccular (32%), fusiform (13%), or microform (55%). The stent types involved were Cypher (n=56, 71.8%) and Taxus (n=22, 28.2%). During a median follow-up period of 1164 days, the incidence of MACE was significantly higher in the CAA group (26.9 vs. 2.2%, P<0.001); the difference was driven mainly by nonfatal MI (11.5 vs. 0%, P<0.001) and TLR (20.5 vs. 1.9%, P<0.001). The incidence of stent thrombosis was higher in the CAA group (12.8 vs. 0.74%, P<0.001), irrespective of the maintenance of dual antiplatelet therapy. In the CAA group, Cox regression analysis showed significantly higher hazard ratios of CAA for MACE during the follow-up period. Further analyses after propensity-score matching of 65 pairs also showed similar results. Conclusions: The incidence of MACE was higher in patients with CAA compared with patients without CAA after DES implantation. This difference was driven by TLR and nonfatal MI and widened over time.
AB - Objectives: We sought to investigate the long-term clinical outcomes of patients with coronary artery aneurysm (CAA) after drug-eluting stent (DES) implantation, compared with patients without CAA. Background: CAA developed after DES implantation is a rare but associated with poor clinical outcome. Methods: We retrospectively compared 78 patients with CAA after DES implantation with 269 patients without CAA who underwent DES implantation for complex lesions (controls). The primary endpoint was defined as major adverse cardiac events (MACE), the composite of all-cause death, nonfatal myocardial infarction (MI), and target lesion revascularization (TLR). Results: Morphologically, CAAs were saccular (32%), fusiform (13%), or microform (55%). The stent types involved were Cypher (n=56, 71.8%) and Taxus (n=22, 28.2%). During a median follow-up period of 1164 days, the incidence of MACE was significantly higher in the CAA group (26.9 vs. 2.2%, P<0.001); the difference was driven mainly by nonfatal MI (11.5 vs. 0%, P<0.001) and TLR (20.5 vs. 1.9%, P<0.001). The incidence of stent thrombosis was higher in the CAA group (12.8 vs. 0.74%, P<0.001), irrespective of the maintenance of dual antiplatelet therapy. In the CAA group, Cox regression analysis showed significantly higher hazard ratios of CAA for MACE during the follow-up period. Further analyses after propensity-score matching of 65 pairs also showed similar results. Conclusions: The incidence of MACE was higher in patients with CAA compared with patients without CAA after DES implantation. This difference was driven by TLR and nonfatal MI and widened over time.
KW - Coronary artery aneurysm
KW - Drug-eluting stent
KW - Major adverse cardiac event
KW - Percutaneous coronary intervention
UR - http://www.scopus.com/inward/record.url?scp=85034748808&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85034748808&partnerID=8YFLogxK
U2 - 10.1002/ccd.27429
DO - 10.1002/ccd.27429
M3 - Article
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
SN - 1522-1946
ER -